BACKGROUND AND OBJECTIVES: Although sentinel lymph node (SLN) biopsy using radioisotope (RI) and blue dye (BD) achieved a high detection rate, approximately 5% of melanomas with negative SLNs develop nodal metastasis. We tested a new lymphatic navigation method using indocyanine green fluorescence imaging (ICG-FI) to detect such "occult" SLNs. METHODS: Thirty-four skin cancer patients received SLN biopsy with the following three methods: RI (99Tc-tin colloid), BD (2% patent blue), and ICG (0.5% indocyanine green). Lymph nodes detected by any of the three methods were counted as SLNs. RESULTS: ICG-FI detected more SLNs in 8 out of the 34 cases (24%). The average numbers of SLNs detected by ICG-FI, RI, and BD were 2.18, 1.76, and 1.73, respectively. Interestingly, ICG-FI not only detected more SLNs in one basin (ICG-FI: 1.64, RI: 1.50, and BD: 1.51 SLNs per basin), but also detected additional SLNs in other basins (ICG-FI: 1.32, RI: 1.18, and BD: 1.15 basins per case). CONCLUSION: ICG-FI detected SLNs more efficiently than did the conventional methods, and these "occult" SLNs may offer an explanation for some false-negative cases. We recommend using ICG-FI in addition to a conventional method to reduce the risk of overlooking these "occult" SLNs.
BACKGROUND AND OBJECTIVES: Although sentinel lymph node (SLN) biopsy using radioisotope (RI) and blue dye (BD) achieved a high detection rate, approximately 5% of melanomas with negative SLNs develop nodal metastasis. We tested a new lymphatic navigation method using indocyanine green fluorescence imaging (ICG-FI) to detect such "occult" SLNs. METHODS: Thirty-four skin cancerpatients received SLN biopsy with the following three methods: RI (99Tc-tin colloid), BD (2% patent blue), and ICG (0.5% indocyanine green). Lymph nodes detected by any of the three methods were counted as SLNs. RESULTS:ICG-FI detected more SLNs in 8 out of the 34 cases (24%). The average numbers of SLNs detected by ICG-FI, RI, and BD were 2.18, 1.76, and 1.73, respectively. Interestingly, ICG-FI not only detected more SLNs in one basin (ICG-FI: 1.64, RI: 1.50, and BD: 1.51 SLNs per basin), but also detected additional SLNs in other basins (ICG-FI: 1.32, RI: 1.18, and BD: 1.15 basins per case). CONCLUSION:ICG-FI detected SLNs more efficiently than did the conventional methods, and these "occult" SLNs may offer an explanation for some false-negative cases. We recommend using ICG-FI in addition to a conventional method to reduce the risk of overlooking these "occult" SLNs.
Authors: Floris P R Verbeek; Susan L Troyan; J Sven D Mieog; Gerrit-Jan Liefers; Lorissa A Moffitt; Mireille Rosenberg; Judith Hirshfield-Bartek; Sylvain Gioux; Cornelis J H van de Velde; Alexander L Vahrmeijer; John V Frangioni Journal: Breast Cancer Res Treat Date: 2013-12-13 Impact factor: 4.872
Authors: B E Schaafsma; F P R Verbeek; H W Elzevier; Q R J G Tummers; J R van der Vorst; J V Frangioni; C J H van de Velde; R C M Pelger; A L Vahrmeijer Journal: J Surg Oncol Date: 2014-08-11 Impact factor: 3.454
Authors: B E Schaafsma; F P R Verbeek; A A W Peters; J R van der Vorst; C D de Kroon; M I E van Poelgeest; J B M Z Trimbos; C J H van de Velde; J V Frangioni; A L Vahrmeijer; K N Gaarenstroom Journal: BJOG Date: 2013-02-19 Impact factor: 6.531
Authors: Kristine E Day; Lauren N Beck; Nicholas L Deep; Joy Kovar; Kurt R Zinn; Eben L Rosenthal Journal: Laryngoscope Date: 2013-04-24 Impact factor: 3.325
Authors: J R van der Vorst; B E Schaafsma; F P R Verbeek; R J Swijnenburg; M Hutteman; G J Liefers; C J H van de Velde; J V Frangioni; A L Vahrmeijer Journal: Br J Dermatol Date: 2013-01 Impact factor: 9.302